One of the leading complications of childbearing are perinatal mental health disorders. These are mental health issues that occur during pregnancy (perinatal), after the birth of the child (postpartum) or after a pregnancy loss. Perinatal mental health disorders can not only affect the birthing parent, but also the non-birthing parent and other family members. Left untreated, these issues can lead to adverse effects for the birthing-parent, the child and the family. In this article, we will be sharing insight on the various perinatal mental health disorders that a parent might experience perinatally or postpartum. Interestingly, many of the issues we discuss here, are less commonly studied (Howard et al 2014) than postpartum depression.
Please note: the term mothers is used instead of birthing parent when the studies included only female (assigned at birth) birthing-parents.
What is postpartum depression?
It is very normal to experience “baby blues” for a few days after giving birth. Birthing parents describe this as feeling unhappy, worried and fatigued almost immediately after delivery. “Baby blues” usually get better within 2 weeks, without intervention (CDC 2022).
A more serious mental health issue that we hear about quite often is postpartum depression (PPD). In 2019, Statistics Canada reported that 23% of mothers reported symptoms consistent with PPD (StatsCan 2019), while 8-10% of fathers are diagnosed (Scarff 2019, Dennis et al., 2022). The difference between “baby blues” and PPD is the severity and length of symptoms. Birthing parents with PPD experience very severe sadness, anxiety and hopelessness. This is usually accompanied by a loss of interest in activities, withdrawal from friends and family and sometimes thoughts of hurting themselves or their baby (CDC 2022). Usually, PPD recovery requires treatment from a medical professional.
What is postpartum anxiety?
Like “baby blues”, some worrying after birth is normal. However, when the worrying turns into anxiety that is persistent and unrelenting it may be postpartum anxiety. Parents who experience this disorder will often feel extreme worrying that something bad will happen, they may feel unable to relax and have a hard time sleeping or eating. 11-21% of birthing parents and 10% of non-birthing parents will experience postpartum anxiety and should seek help from a medical professional to get treatment.
What is perinatal or postpartum Obsessive Compulsive Disorder (OCD)?
Parents can experience OCD during the pregnancy (2-22% of mothers) or after the birth of the child (2-24% of mothers). Mothers who have pre-existing OCD, may experience more severe symptoms and worsening of their disorder. Perinatal or postpartum OCD is characterized by obsessions (intrusive thoughts, ideas, images or impulses), compulsions (repetitive or ritualistic behaviours) or both, that greatly interfere with daily functioning. OCD with onset in the perinatal period (before birth) often appears as obsessions with contamination (cleaning and washing compulsions), while postpartum onset often appears as obsessions with harming the baby and aggressive intrusive thoughts (Hudepohl et al., 2023). Usually, the parents are deeply disturbed by their intrusive thoughts and will protect the baby at all costs, ensuring no harm. OCD during this period of life is understudied and there are no specific treatments for perinatal or postpartum OCD, however, regular OCD treatments are possible.
What is postpartum or puerperal psychosis?
Postpartum (or puerperal) psychosis is a very serious mental health disorder that requires immediate medical attention, it can progress very rapidly and lead to harmful situations for the parents and child. Mothers with bipolar disorder have a 50-80% chance of experiencing postpartum psychosis (Friedman et al., 2023). Postpartum psychosis can present suddenly within the first few weeks postpartum. Symptoms can include:
- hallucinations: hearing, seeing, smelling things that aren’t there
- delusions: suspicions, fears often about the baby that likely aren’t true
- mania: feeling very “high”, talking too much and too quickly, losing normal inhibitions
- low mood: showing signs of depression, lacking energy, loss of appetite, trouble sleeping, agitation
a major distinction between the impulsive thoughts felt with postpartum OCD and psychosis is that the OCD parent realizes that harming the baby is not an option, while in psychosis, the parent is experiencing a different reality and can’t realize
What is postpartum Post-Traumatic Stress Disorder (PTSD)?
When a parent perceives or experiences a traumatic birth (extreme fear, birth complications or lack of support) they can experience postpartum PTSD. Both the birthing and non-birthing parent can be at risk for developing symptoms related to the disorder that include flashbacks of the traumatic event, nightmares, anxiety or panic attacks, feeling a sense of detachment and avoiding the aftercare instructions for optimal healing. PTSD can be treated through consult with a medical professional.
Why is perinatal mental health important?
The perinatal period can bring about a wide range of mental health challenges, many of which are not often discussed openly. While this is not an exhaustive list, it’s essential to acknowledge that feeling different after pregnancy is normal—and support is available. If you’ve experienced any of these challenges, your story matters. We’d love to hear your experiences and support you in the Reflective Parent Club, where we explore ways to manage emotions, share insights, and reflect together.
Let’s raise awareness about the more severe mental health issues surrounding childbearing, so parents can feel informed, prepared, and empowered. Join us for free for 7 days and be part of the conversation that normalizes these important discussions.
This article was written in collaboration with the Da Costa Lab that researches parents’ well-being during the transition to parenthood.
